Forensic psychiatry training sites

Jail Psychiatric Services

The Sacramento County Main Jail is located in the heart of downtown Sacramento. The jail houses 2,400 inmates with an 18-bed inpatient psychiatric unit. Approximately 20% of the inmates in the jail have a prior psychiatric history.

The forensic psychiatry resident provides psychiatric evaluations for the jail "outpatient" clinic. During this clinical experience, the resident goes to various housing units within the jail and assesses inmates with potential mental health issues. The resident also consults with general medical physicians regarding the interface of alcohol and drug withdrawal with potential suicidality. Educational opportunities include bi-weekly case conferences and individual supervision. Assigned supervisors have added qualifications in forensic psychiatry and provide ongoing supervision.

Napa State Hospital

Napa State Hospital is nestled in the heart of the Napa Valley wine country. The hospital has approximately 1100 beds with specialized units housing a range of forensic psychiatric patients. The forensic psychiatry resident spends one day a week at this site during the 12 month training. The residents provide forensic consultation to general psychiatrists. Examples of consultations include competency to manage financial affairs, pharmacologic management of aggression, right to refuse treatment, and assessment of dangerousness. The forensic resident reviews the case with a forensic faculty member followed by a case conference with members of the patient's treatment team.

The forensic psychiatry resident also consults with the competency restoration unit which houses approximately 70 patients who have been found incompetent to stand trial. The forensic resident participates in mock trials held in a simulated courtroom to help determine the patient's knowledge of his charges and his ability to assist his attorney in his defense. The resident also writes forensic reports on patient's competency to stand trial.

On-site educational training includes weekly consultation liaison case conferences, bi-weekly case conferences addressing competency to stand trial or conditional release, weekly grand rounds, and participation in hearings assessing a person's right to refuse treatment. Direct supervision is provided by forensic faculty who have either completed a residency in forensic psychiatry or who have added qualifications in forensic psychiatry.